Mental illness prevalent among prison inmates

NEW YORK (Reuters Health) – One in seven inmates in western nations' prisons may have a serious mental illness, and it is unclear if the systems have the capacity to care for them, according to UK researchers.

"Worldwide, several million prisoners probably have serious mental disorders, but how well prison services are addressing these problems is not known," they report in the February 16th issue of The Lancet.

Researchers at Oxford and Cambridge Universities reviewed more than three decades' worth of studies from western nations–including the UK, US, Australia, Canada and Finland–and found high rates of psychosis, major depression and antisocial personality disorder among male and female prisoners.

Compared with the general US and UK populations, psychotic illness and major depression were two to four times more common among prisoners. Antisocial disorder was 10 times more common, according to Dr. Seena Fazel and John Danesh.

Across studies, the investigators found, about 4% of male and female prisoners had been diagnosed with psychotic illness, with rates higher in US studies than in those performed in other countries. Overall, 10% of men and 12% of women had been diagnosed with major depression.

Antisocial personality disorder was diagnosed in nearly half of male prisoners and one fifth of female prisoners.

Dr. Fazel and Danesh estimate that in the US, "a few hundred thousand" prisoners might have a psychotic illness, major depression, or both. This estimate, they note, would be about twice the number of patients in US psychiatric hospitals.

"Given the limited resources of most prisons, however," they add, "it seems doubtful whether most prisoners with these illnesses receive appropriate care."

The ability of prison systems in some countries to deal with the problem of mental illness "may well require review," according to Dr. Fazel and Danesh. They also note that more research needs to look at prisons in non-western countries.

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